Thursday, November 29, 2012

Nightmares: An Experiment in Anxiety Management by @Aspiemusings || AutismAid

Nightmares: An Experiment in Anxiety Management

Warning: This contains some nongraphic descriptions of violent/disturbing nightmares.

I have a lot of nightmares. If the statistics at WebMD are correct, I fall into the 2-8% of the adult population that has nightmares more than once a month. I’d love to know the percentage of people who have nightmares more than once a week. I bet that would make me feel really special.

Lately, though, I’m getting fed up with the nightmares. I’m ready to get myself into the 90+ percent of people who don’t regularly dream about being chased and assaulted.

Locating the Source of the Problem

Recently I began to suspect that my nightmares were related to my Asperger’s. Since finding out that I’m an aspie, this has been my default explanation for anything out of the ordinary.

Some digging through the PubMed database failed to turn up any research strongly linking nightmares and autism. Autistic kids are known to have a very high incidence of sleep disorders (look for a separate post on this next week). Some studies reported that as many as 80% of children with ASD have some form of insomnia. But nightmares haven’t been strongly linked to autism in children and, not surprisingly, there were no studies on sleep disorders in autistic adults.

My next stop was Google. If Asperger’s wasn’t to blame, I needed to find a likely suspect, and where better to hunt for clues than the internet, right?

Visits to WebMD and the International Association for the Study of Dreams turned up good background information about adult nightmares. I scanned through the common causes: medication or withdrawal from medication/alcohol, late-night snacking (because it increases metabolism), a traumatic event, PTSD, anxiety, stress, depression.

Aha! There it was. Anxiety. Asperger’s was to blame after all.

Sort of.

Connecting the Dots

Since I’ve been paying closer attention, I’ve noticed that my nightmares fall into two categories: violent or rage-filled.

The violent nightmares are closer to what most people think of when they think nightmare: being chased, being attacked, being seriously injured. The threatening person (or people) is always a stranger. The dreams used to end in me being seriously injured or nearly dying. A few years ago they shifted. Now the violent dreams almost always end with me seriously injuring or killing the attacker(s). If this sounds like an improvement, trust me, it’s not.

The rage-filled nightmares are characterized by me getting extremely angry with someone I know and blowing up at them. I’m not the kind of person who screams and rages at people in my waking life, so doing it in a dream is strange and disturbing. The rage feels uncontrollable and far more extreme than anything I’ve ever experienced in a sustained way while awake. It feels like I’ve snapped.

Over time, I’ve noticed a pattern in when I have nightmares. I can go weeks without a bad dream and then I’ll have a string of nights filled with long vivid nightmares.

The trigger for each of the types is specific, too. The violent nightmares usually follow a day where I’ve had a frustrating social encounter with a stranger or acquaintance–something that’s left me feeling tongue-tied, inadequate or embarrassed. The rage-filled nightmares usually follow an unpleasant interaction with someone I know. Often that person will be the target of the rage in the dream.

Armed with this analysis, I went off in search of remedies.

A Possible Solution

One of the most common suggestions I found for reducing nightmares was journaling. I’ve tried journaling in the past, unsuccessfully, because part of my brain spends the whole time going “why are we writing this if no one is going to read it?” But the underlying principle of using journaling to process my anxiety makes sense.

My hypothesis about my nightmares: When a trigger event occurs, I’m not processing the feelings associated with it. The lack of processing in my conscious mind is forcing my subconscious to process the feelings, resulting in the unpleasant dreams.

So here is my Aspergarian solution: a spreadsheet. I’m going to track suspected trigger events and nightmares–along with a couple of other variables, like hormonal fluctuations–to see if there’s any relationship between the two.

Ideally, I’d also like to recognize triggering events and try to conscious process the feelings associated with them, no matter how unpleasant that might be. Avoiding them obviously isn’t working. Maybe making a deliberate attempt to look at the triggering situation, acknowledge what I’m feeling and then tell myself that it’s okay to feel that way will diffuse the power of the triggering events and lessen the frequency of the nightmares.